Journal article
Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome: insights from the LUNG SAFE study
Critical care (London, England), Vol.24(1), pp.125-125
03/31/2020
DOI: 10.1186/s13054-020-2826-6
PMCID: PMC7110678
PMID: 32234077
Abstract
Background
Concerns exist regarding the prevalence and impact of unnecessary oxygen use in patients with acute respiratory distress syndrome (ARDS). We examined this issue in patients with ARDS enrolled in the Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study.
Methods
In this secondary analysis of the LUNG SAFE study, we wished to determine the prevalence and the outcomes associated with hyperoxemia on day 1, sustained hyperoxemia, and excessive oxygen use in patients with early ARDS. Patients who fulfilled criteria of ARDS on day 1 and day 2 of acute hypoxemic respiratory failure were categorized based on the presence of hyperoxemia (PaO2 > 100 mmHg) on day 1, sustained (i.e., present on day 1 and day 2) hyperoxemia, or excessive oxygen use (FIO2 ≥ 0.60 during hyperoxemia).
Results
Of 2005 patients that met the inclusion criteria, 131 (6.5%) were hypoxemic (PaO2 < 55 mmHg), 607 (30%) had hyperoxemia on day 1, and 250 (12%) had sustained hyperoxemia. Excess FIO2 use occurred in 400 (66%) out of 607 patients with hyperoxemia. Excess FIO2 use decreased from day 1 to day 2 of ARDS, with most hyperoxemic patients on day 2 receiving relatively low FIO2. Multivariate analyses found no independent relationship between day 1 hyperoxemia, sustained hyperoxemia, or excess FIO2 use and adverse clinical outcomes. Mortality was 42% in patients with excess FIO2 use, compared to 39% in a propensity-matched sample of normoxemic (PaO2 55–100 mmHg) patients (P = 0.47).
Conclusions
Hyperoxemia and excess oxygen use are both prevalent in early ARDS but are most often non-sustained. No relationship was found between hyperoxemia or excessive oxygen use and patient outcome in this cohort.
Details
- Title: Subtitle
- Hyperoxemia and excess oxygen use in early acute respiratory distress syndrome: insights from the LUNG SAFE study
- Creators
- Fabiana Madotto - University of Milano-BicoccaEmanuele Rezoagli - University of Milano-BicoccaTài Pham - University of TorontoMarcello Schmidt - University of TorontoBairbre McNicholas - Ollscoil na Gaillimhe – University of GalwayAlessandro Protti - Humanitas UniversityRakshit Panwar - John Hunter HospitalGiacomo Bellani - University of Milano-BicoccaEddy Fan - Ollscoil na Gaillimhe – University of GalwayFrank van Haren - Australian National UniversityLaurent Brochard - University of TorontoJohn G. Laffey - St Michael's HospitalEuropean Society of Intensive Care Medicine (ESICM) Trials GroupLUNG SAFE Investigators
- Contributors
- Nicholas M Mohr (Contributor) - University of Iowa, Anesthesia
- Resource Type
- Journal article
- Publication Details
- Critical care (London, England), Vol.24(1), pp.125-125
- DOI
- 10.1186/s13054-020-2826-6
- PMID
- 32234077
- PMCID
- PMC7110678
- NLM abbreviation
- Crit Care
- ISSN
- 1364-8535
- eISSN
- 1466-609X
- Publisher
- BioMed Central
- Grant note
- ;
- Language
- English
- Date published
- 03/31/2020
- Academic Unit
- Epidemiology; Emergency Medicine; Anesthesia; Injury Prevention Research Center
- Record Identifier
- 9984296137402771
Metrics
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